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From an anthropological perspective, health is largely viewed as a state of physical, mental and social well-being shaped by a complex interplay of biological, environmental and social cultural factors. The scholarly contributions of anthropology in understanding health and illness narratives, social inclusion, equity and diversity are monumental and profoundly innovative. More importantly, the social, cultural, economic, political and environmental determinants of health are deeply entwined, influencing and shaping each other in complex and challenging ways.
 

My recent ethnographic field research in Raksirang of Makwanpur was an interesting and humbling experience in terms of exploring health and illness narratives of indigenous and socially-excluded communities such as Chepangs. Moreover, my intellectual curiosity was to understand how local governments have been responsive to these communities in terms of inclusive policies to enhance their easy access to basic health care and other social protection services. 

Within and across societies, illness is largely viewed as a culturally interpreted subjective experience of becoming unwell. Such an experience is influenced by a range of factors such as age, gender, social status and access to health care. Additionally, indigenous knowledge and practices are deeply embedded in social and gender relations, cultural norms, values and religions. 

The ethnographic insights from the fieldwork have offered new frameworks for examining and exploring how indigenous communities are organized, and their knowledge, understanding and experiences of health care are shaped by cultural norms and social hierarchies.
 

Seeking health care is largely a social process. The way people and health care providers interact is influenced by culture. Interactions such as eye contact and language are also important to make people more comfortable in accessing health care. The systemic barriers such as discrimination or bias often yield worse health outcomes. 

The intersection of health and illness is an interesting area of exploration. It helps explain how relationships and power dynamics within and across social structures in local health systems have enabled or constrained the agency of the local communities in accessing health care. 

My understanding on reflective approach to ethnography was meaningful in terms of enriching ethnographic data and ensuring a more nuanced understanding of local perspectives on inclusive health governance.
 

Listening to interesting stories of Chepangs about their health and illness narratives, my questions about why they do the way they do are variously answered. The stories about illness are not just accounts of personal experience but also reflect cultural values and beliefs about health and healing. Their age-old practices to seek health care from natural resources, traditional healers, religious and spiritual leaders do exist. But they have started to visit health facilities and consult with health workers or volunteers for health care.
 

Michael Taussig, a doctor and anthropologist, argues that understanding illness requires attention not only to biomedical models but also to the subjective experiences of individuals who are ill. The emphasis is more on the importance of illness narratives in understanding local health care practices. By examining how people experience illness at a personal level, Taussig provides insight into how medical practices shape individual experiences and social structures.

Interestingly, the shamanic practices of the indigenous communities are culturally constructed and historically nurtured.  In recent years, with public health awareness, local government’s inclusive priorities for health, education and improved infrastructure such as housing, rural road, water and sanitation and telecommunications, the livelihoods of indigenous communities have greatly improved. 

Instead of a health post, now there is a rural hospital in Raksirang which has good health infrastructure and trained human resources. Local government provides additional allowance to mothers who are pregnant and deliver in hospital to encourage the communities for institutional delivery and immunizations. Nutrition allowance to families is another local initiative to address malnutrition and other social protection services in need.

Despite noted progress, the reality is still different. Poor and socially marginalized communities in remote areas of Raksirang have limited access to essential health care. There are little efforts exploring how individuals and communities perceive, experience and cope with what they understand about illness. Moreover, the importance of understanding local healing traditions and practices is overlooked as it can impact how the communities respond to illness or disease.

Going beyond biology, a more holistic understanding of health and illness is required in the changed socio-political context. More specifically, there needs to be a more inclusive and reflexive understanding of political leaders, officials of local government, health workers and civil society activists to promote intersectionality approach in planning and delivering health care services. 

In addressing most pressing health challenges, anthropological perspectives can contribute to shape the future of health and social well-being by developing culturally appropriate interventions and advocating for health equity. Evidence suggests that social, economic and political structures have profound implications on health outcomes. Moreover, social inequalities significantly contribute to health disparities and social injustice within and across social groups.

As we move forward, a broader socio-cultural approach helps local governments to be more creative, accountable and responsive to the unmet health care needs of communities which are culturally appropriate. Moreover, it is high time to critically challenge the traditional ways of thinking about illness, medicine and health care, and build a resilient and sustainable system for health.

The author is a health policy analyst

The recent meeting between Nepali Prime Minister KP Sharma Oli and Indian Prime Minister Narendra Modi on the sidelines of the BIMSTEC summit in Thailand has sparked cautious optimism about the trajectory of bilateral relations. The one-on-one discussion, described by observers as potentially ice-breaking, comes against the backdrop of an unusually prolonged delay in arranging an official visit by Oli to New Delhi—a standard diplomatic protocol that typically follows a change of government in Nepal.

Ten months into Oli’s third term, the absence of an official invitation from India has fueled speculation about underlying tensions between the two neighbors. Diplomatic sources suggest several factors may be contributing to the hesitation, including Nepal’s deepening engagement with China through initiatives like the Belt and Road Initiative (BRI) framework agreement, which has reportedly caused discomfort in New Delhi.

Minister for Foreign Affairs Arzu Rana Deuba had previously indicated that preparations were underway for reciprocal visits by both prime ministers, but her recent silence on the matter suggests recalibrated expectations. Prime Minister Oli himself offered an unusually muted explanation upon returning from Thailand, stating simply that his India visit wasn’t happening due to his busy schedule and might occur “if time permits.” This contrasts with his more enthusiastic pronouncements about bilateral relations during previous terms.

Historical context suggests such delays aren’t unprecedented—former Prime Minister Sher Bahadur Deuba waited nine months after taking office in 2021 before visiting India. However, the current situation appears more complex, with Indian officials privately emphasizing their desire for any high-level visit to yield substantive outcomes, possibly including the inauguration of joint infrastructure projects. “There’s no major obstacle,” one senior Indian official noted, “but we want the visit to demonstrate tangible progress in the relationship.”

The delay in the prime minister’s visit to India does not mean that there is a lack of communication between the two governments. Oli and Modi first met on the sidelines of the 78th General Assembly of the United Nations in September last year. Since then, Foreign Minister Deuba has also held meetings with Indian Prime Minister Modi and her Indian counterpart S Jaishankar.

Officials say though there hasn’t been a prime ministerial-level exchange between Nepal and India,  meetings of all bilateral mechanisms have been taking place to address mutual concerns and issues. There have also been ministerial level visit exchanges and more are lined up in the imminent future. 

A senior official at the Office of the Prime Minister and Council of Ministers said, “The delay in the prime minister’s India visit doesn’t mean that the ties between Nepal and India have stalled, because all bilateral engagements are sailing in a smooth manner.”

Following the Thailand meeting between Oli and Modi, India’s Ministry of External Affairs released a carefully worded statement emphasizing continued cooperation in connectivity, energy and people-to-people ties, while conspicuously avoiding mention of more sensitive issues. The statement reaffirmed Nepal’s importance under India’s ‘Neighborhood First’ policy, suggesting an effort to project normalcy despite the evident diplomatic awkwardness.

The aborted plan for Modi to attend Nepal’s Sagarmatha Sambaad dialogue in May—ostensibly due to scheduling conflicts with a European trip—highlighted some of the coordination challenges for high-level exchanges. Nepali officials acknowledge the late invitation may have been a logistical misstep, but some analysts see it as emblematic of broader communication gaps.

“Look closely at nature. Every species is a masterpiece, exquisitely adapted to the particular environment in which it has survived. Who are we to destroy or even diminish biodiversity?” The quote by EO Wilson, a pioneer biologist, emphasizes the intrinsic value of every species and its role in maintaining biodiversity and ecosystem balance. All species, including humans, are integral to the web of life, each contributing to ecosystem resilience. As humans, we hold immense power over nature, yet this power comes with the responsibility to protect biodiversity rather than diminish it.

Our actions, such as habitat destruction and the spread of invasive species, disrupt ecosystems and threaten our own survival, highlighting the ethical imperative to preserve the intricate interdependence of life. 

Invasive alien species (IAS) are non-native organisms introduced to new habitats through human activities, intentionally or accidentally, that disrupt ecosystems and threaten biodiversity. Without natural predators, IAS often proliferate rapidly, outcompeting native species and driving them to extinction. Their spread causes irreversible biodiversity loss, alters ecosystem services and incurs colossal economic and social costs. Globalization, trade, travel and climate change have further accelerated IAS spread, making them one of the top five drivers of biodiversity loss, contributing to native species extinction, noted by IPBES, 2019. Globally, around 37,000 IAS are established.

Pyšek et al (2020) reported that around 14,000 species with established alien populations represent four percent of global flora, while 175 terrestrial gastropods as IAS across 56 countries, 745 of 15,000 freshwater fish species, and 971 out of 2000 bird species have become established IAS across various regions.

Growing global perils

IAS are major drivers of biodiversity loss and native species extinction, often referred to as ‘biological pollution’ or ‘green cancer’ (Olson, 2006), while also posing risks to human health, food security and livelihoods. For example, the brown tree snake (Boiga irregularis) led to the extinction of 10 bird species on Guam after its introduction in the 1940s. The IAS Asian tiger mosquito (Aedes albopictus) spreads diseases—Dengue, Chickungunya, and West Nile virus, affecting millions globally. Water hyacinth (Eichhornia crassipes), native to South America, introduced for ornamental purposes across the world, invades water bodies, irrigation channels and rice paddies, causing ecological and economic calamity. IAS disrupt critical ecosystem services such as pollination, water purification and soil fertility, essential for natural cycles. Their spread, accelerated by global trade and travel, worsens these risks, undermining public health and economic resilience.

Economic toll associated with IAS is staggering. A study by Diagne et al (2021) in Nature estimated biological invasions have caused a minimum global economic cost of $1.288trn between 1970 and 2017. According to the IUCN, IAS cost €12.5bn annually and Australia AUS$13.6bn each year. Invasive insects alone account for $70bn in global annual losses. IAS damages agriculture, reduces fishery yields, and disrupts urban areas, leading to financial losses and increased management costs. Prominent IAS in the US, including the spotted lanternfly, red fire ant, feral swine, Emerald ash borer,

Asian carp and Burmese python, purple loosestrife, Japanese honeysuckle, barberry, English Ivy and Kudzu have altered ecosystems and incurred billions of dollars in control efforts and lost productivity. IAS like zebra mussels, native to the Caspian Sea, damage aquatic ecosystems, while the Spanish slugs devastate crops in Europe with massive economic damage.

Furthermore, IAS threaten food security and livelihoods, hindering progress toward the UN's SDG 15 aiming to protect life on land and below water. The IUCN Red List of Threatened Species (2022) reports that one in ten species on the list are threatened by IAS, emphasizing the urgent need for coordinated global efforts to mitigate their spread protecting ecosystem resilience.

The context of Nepal

IAS pose escalating threats to Nepal’s ecology, economy, sustainable development and health, reflecting global concerns. IAS in Nepal have a long history, with Chomolaena odorata (Siam weed) first reported in 1825. Known locally as ‘Banmara’,  these species disrupt ecosystems, outcompete native species, and threaten agricultural productivity. An estimated 219 alien flowering plant species in Nepal’s forests, with 30 flora species are common IAS (Yadav et al, 2024). Budha 2014 reported 69 fauna species; insects (21), fish (16), birds (three), wild mammals (two), freshwater prawn (one), platyhelminthes (one) and livestock breeds (25 improved breeds), identified as common IAS. These species are primarily from the Americas (74 percent), Europe (one percent) and Africa (eight percent) and cause irreparable harm to ecology.

The introduction of IAS is driven by increasing tourism, trade and limited institutional biosecurity capacity, including insufficient policies and quarantine facilities. These conditions provide a conducive environment for exotic species. Notable flora IAS are Ageratina adenophora, Chromolaena odorata, Eichhornia crassipes, Lantana camara, and Mikania micrantha. Specifically, C odorata, E crassipes, L camara and micrantha are listed among the world’s worst IAS. Tomato leaf miner (Tuta absoluta) and Fall armyworm (Spodoptera frugiperda) harm crops, and giant African snail (Achatina fulica) spoils vegetables.

The economic cost of managing IAS, such as Tilapia in water bodies, water hyacinth in the Fewa Lake, and Mimosa diplotricha in Jhapa’s community forests, is substantial, requiring extensive resources. However, the ecological, evolutionary and economic impacts of IAS remain under-studied, with a lack of evidence-based management strategies. While physical removal is common, bio-controls have yet to be formally implemented.

Nation-wide surveys, standardized guidelines, policy-advocacy and community awareness are warranted to address IAS.

IAS pose a silent threat, eroding biodiversity and economic stability globally. While developed nations combat established invaders, countries like Nepal face escalating risks due to weak biosecurity defenses and increasing climate change concerns. Proactive measures including stronger policies, scientific research and global cooperation are essential to mitigate these growing perils. Without urgent action, the ecological and economic consequences will be irreversible.

As Wilson’s call to action reminds us, we must reconsider our role as biodiversity stewards and safeguard ecosystems for future generations. Addressing the critical challenges from IAS requires proactive policies, enhanced cross-cutting research and stronger multi-stakeholder engagement to prevent further damage to the nation’s rich biodiversity.

The author is a biological scientist

Indian Prime Minister Narendra Modi said that he had a productive meeting with Prime Minister KP Sharma Oli in Bangkok.

Taking to Twitter, he said, “India attaches immense priority to relations with Nepal. We discussed different aspects of India-Nepal friendship, especially in sectors like energy, connectivity, culture and digital technology.” “We also talked about some of the key positive outcomes from this year’s BIMSTEC Summit, especially in the areas of disaster management and maritime transport."

The two Prime Ministers had a one-on-one meeting for about 45 minutes at Hotel Mandarin Oriental in Bangkok, Thailand.

The meeting took place as per the schedule after the conclusion of the Sixth Summit of the Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC).

Earlier, they had met in New York on September 23, 2024 on the sidelines of the 79th Session of the United Nations General Assembly.